Written questions by Yasin.

Whether his Department is considering the introduction of standardised written agreements or minimum documentation requirements for care arrangements involving local authority oversight, in order to improve clarity on payment responsibilities and reduce the risk of disputes.

Under the Care Act 2014, local authorities are best placed to understand and plan for the needs of their population, which is why they are tasked with the duty to shape their care markets to meet the diverse needs of all local people, including implementing care arrangements that are transparent and put the people drawing on care at the centre of decisions.Also, under the Care Act, charging is based on a number of principles, including that people should not be charged more than it is reasonably practicable for them to pay and that charging approaches should be clear, transparent, and comprehensive so people know what they will be charged.Where local authorities decide to charge for the provision of care and support, they must follow the Care Act and the Care and Support (Charging and Assessment of Resources) Regulations 2014, and they must act under the Care and Support Statutory (CASS) guidance.The responsibility for applying the law and the CASS guidance rests with local authorities, and they should ensure that their approaches to charging are clear and transparent, so people know what they will be charged.

What assessment he has made of the clinical and cost effectiveness of first-line use of encorafenib in combination with cetuximab and chemotherapy for patients with BRAF V600E-mutant metastatic colorectal cancer; and whether he has set a timetable for consideration by the National Institute for Health and Care Excellence of this treatment approach for routine NHS use.

The BREAKWATER study is investigating encorafenib, a BRAF inhibitor, in combination with cetuximab and fluorouracil-based chemotherapy for the potential treatment of colorectal cancer. This regimen does not currently have a United Kingdom marketing authorisation for use in the treatment of previously untreated BRAF V600E mutation positive metastatic colorectal cancer.The National Institute for Health and Care Excellence has prioritised an appraisal of encorafenib for this indication in anticipation of it being granted a UK marketing authorisation and will schedule the appraisal so that guidance can be published as close as possible to the expected licensing date.

What steps his Department is taking, as part of the National Cancer Plan for England, to ensure equitable and timely access to innovative cancer treatments across England, including for patients with advanced bowel cancer; and what assessment he has made of variation in access to targeted therapies between England and other UK nations.

The National Cancer Plan published in February 2026, sets out how we will ensure equitable and timely access to cancer care and treatment and improve outcomes for thousands of patients across England. It will shift healthcare from hospitals to the community and ensure that all cancer patients, regardless of where they live, have timely access to high-quality, specialist cancer services, including for those with advanced bowel cancer. National Health Service regions and Cancer Alliances will jointly identify underperforming trusts and provide intensive support including leadership intervention, peer-to-peer mentoring, and seconding senior managers from stronger trusts. Cancer Alliances will have access to £200 million of ringfenced cancer funding in 2026/27 to improve cancer pathway performance, reduce delays, and speed up diagnosis, ensuring that all patients, including those with advanced bowel cancer, receive the care and treatment they need when they need it.

What progress he has made on the development of the Palliative Care and End of Life Care Modern Service Framework for England; what his planned publication timetable is; and how the proposed framework will help reduce variation in access to palliative and end of life care services across Integrated Care Boards.

An interim product on the Modern Service Framework (MSF) for Palliative Care and End-of-Life Care is due in Spring, with full publication planned for Autumn.The MSF will provide a clinically-led, evidence-based framework to support sustained improvement in patient and carer outcomes, including narrowing inequality and reducing unwarranted variation. Areas of action will be identified for those commissioning and delivering services with associated performance and outcome metrics to support system accountability.

Whether he has visited an Integrated Retirement Community; and what assessment he has made of the potential impact of modern housing-with-care schemes on older people's health.

We recognise the role integrated retirement communities play in providing high quality, safe, and suitable homes which can help people stay independent and healthy for longer and which reduce the need to draw on health and social care provision.We have not made an assessment on the impact this specific type of housing provision has on older people’s health, but the Government is committed to enhancing the provision and choice for older people in the housing market.My Rt Hon. Friend, the Secretary of State for Health and Social Care, has not undertaken a visit to an integrated retirement community to date.

What assessment his Department has made of the adequacy of current requirements for the provision of carbohydrate and nutritional information in restaurants and other out-of-home food settings for people living with Type 1 diabetes.

Legislation requiring large businesses in England, those with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in April 2022.The Department carefully considered the views of a wide range of experts in response to the public consultations on calorie labelling, including expert advice from organisations such as Diabetes UK. A careful balance needed to be struck between making calorie labels as accessible and informative as possible for consumers while not disproportionately impacting businesses. It was decided that large businesses, who are responsible for nearly half of all food and drink sales, would only be required to display calorie information. This ensures that the regulations deliver the projected health benefits while minimising the risk of disproportionately burdening smaller businesses who might find the new requirement more challenging to implement. It is at the discretion of an individual business if they choose to display additional nutritional information, such as carbohydrates, on their menus.We continue to evaluate the impact of the Out of Home Calorie Labelling Regulations and will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy.

What assessment his Department has made of the adequacy of current what assessment his Department has made of the potential impact of the absence of mandatory carbohydrate labelling in restaurants on the safety and clinical outcomes of people with Type 1 diabetes.

Legislation requiring large businesses in England, those with 250 or more employees, to display calorie information on non-prepacked food and soft drinks came into force in April 2022.The Department carefully considered the views of a wide range of experts in response to the public consultations on calorie labelling, including expert advice from organisations such as Diabetes UK. A careful balance needed to be struck between making calorie labels as accessible and informative as possible for consumers while not disproportionately impacting businesses. It was decided that large businesses, who are responsible for nearly half of all food and drink sales, would only be required to display calorie information. This ensures that the regulations deliver the projected health benefits while minimising the risk of disproportionately burdening smaller businesses who might find the new requirement more challenging to implement. It is at the discretion of an individual business if they choose to display additional nutritional information, such as carbohydrates, on their menus.We continue to evaluate the impact of the Out of Home Calorie Labelling Regulations and will publish a post-implementation review within five years of implementation which will consider the effectiveness and impact of the policy.

What assessment he has made of the potential merits of introducing a (a) tuition fee remission and (b) loan-forgiveness scheme for students who commit to a period of service in the NHS following graduation.

The Government has no current plans to pay loan instalments for healthcare students or to write off student loan debt in exchange for service in the National Health Service.The Government keeps the funding arrangements for students under close review and must make sure that finite financial resources are balanced with the level of support students require. This ensures that we make the best use of public funds to deliver value for money.The Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10 Year Workforce Plan will ensure the NHS has the right people in the right places with the right skills to care for patients, when they need it.

Whether his Department recognises problem debt as a public health issue; and what support the NHS and social care services provide to people with problem debt.

Research shows that there is a link between health and financial health with a large amount of people who experience mental health problems also struggling with their finances.NHS Talking Therapies has recently collaborated with the Money and Pensions Service to promote the Money Guiders programme that helps equip mental health practitioners to have money conversations with their patients. In addition, each NHS Talking Therapies service has embedded employment advisors who provide a non-clinical support service to help patients using Talking Therapies to address work-related issues, offering practical support and solutions for any work barriers which can include unemployment and returning to work.The Individual Placement and Support is a well‑evidenced, National Institute for Health and Care Excellence‑approved employment programme, funded by NHS England, that offers intensive, individually tailored support to get people into work, with ongoing support for the employer and employee to help ensure the person keeps their job.Individuals may also be able to access the Breathing Space Scheme, which was set up to encourage more people in problem debt to access professional debt advice. A standard breathing space provides a 60-day period of protection by pausing creditor enforcement action and most interest, fees, and charges. Given the link between problem debt and mental health difficulties, the Mental Health Crisis Breathing Space was also established for individuals who are receiving mental health crisis treatment.Where debt is the result of gambling addiction, individuals can access their local National Health Service gambling service via self- or professional referral.

What pilots or trials are being planned to reduce drug-related deaths in areas with the highest rates of overdose.

Local authorities are responsible for assessing local need for drug prevention, treatment, and recovery in their areas and for commissioning services to best meet local need. This includes work to reduce drug-related deaths.The Department has recently launched the Drug and alcohol-related deaths dashboard, which provides information on the levels of drug and alcohol related mortality and harms, and the evidence-based interventions that local authorities and treatment providers can provide to have a positive impact on reducing deaths. Local authorities have access to this dashboard and can use it to assess need and plan interventions including in areas with higher rates of deaths. We are also improving surveillance of emerging harms and drug use patterns, with quarterly surveillance data now published to support local police and health responses to synthetic opioids.In response to increasing drug related deaths, in 2024 the Department amended the Human Medicines Regulations 2012 to expand access to naloxone. The legislation enabled more services and professionals to supply this medication. The Department has recently launched a 10-week United Kingdom-wide public consultation on further legislative options to expand access to take-home and emergency use naloxone.In response to the sharp rise in deaths involving cocaine, 800 deaths in 2022 to 1,195 deaths in 2024, the Department is investing an additional £200,000 in 2025/26 to develop and trial new brief interventions to target the rise in cocaine and alcohol-related cardiovascular deaths, particularly among men. The pilots will be run in acute hospital alcohol care teams with a view to making them available for use nationally across all healthcare settings in the next financial year.Through the Government's Addiction Healthcare Goals Reducing Drug Deaths Innovation Challenge, twelve projects have received UK and Scottish government funding to develop and test innovative drug overdose detection, response, and rescue technologies and medicines with relevant populations. Future funding and support through the Addiction Healthcare Goals programme are being explored to further enable the advanced development and UK roll-out of novel drug and alcohol addiction technologies to improve healthcare and prevent harms and deaths.

What plans his Department has to expand access to drug checking services, naloxone, and other overdose prevention measures.

Every drug-related death is a tragedy, and the Government is taking a public health approach to prevent these deaths and reduce harms from drugs.Expanding access to naloxone, a life-saving overdose medication, has never been more important. In addition to the changes made in 2024 to expand access, we recently launched a ten-week United Kingdom-wide public consultation on further legislative options to expand access to take-home and emergency use naloxone.The Government facilitates Drug Checking Facilities provided that the possession and supply of controlled drugs are licensed by the Home Office, or exceptionally, relevant exemptions under the Misuse of Drugs Regulations 2001 may apply.  Drug Checking Facilities must not condone drug use and should only be delivered where licensed and operated responsibly in line with Government policy to ensure that they discourage drug use and signpost potential users to treatment and support.

What assessment he has made of trends in the level of corn allergies; whether he plans to include corn on the list of major allergens emphasised on food labels; and what steps he is taking to ensure that people with rare but clinically significant allergies can safely identify allergens in packaged foods and when eating out.

There are a large number of potential food ingredients that may cause allergic reactions in sensitised individuals. The current 14 regulated allergens are recognised as the most common and potent allergens of public health concern across Europe. They must be clearly identified on prepacked foods and communicated effectively when eating out.Available evidence, though limited, suggests corn allergy remains rare in the United Kingdom, with no indication of an increasing trend, and it is not part of the current list of regulated allergens.The Food Standards Agency (FSA) ensures that labelling requirements enable consumers to make informed choices about all ingredients, including corn.Food businesses must provide clear and accessible allergen information. For prepacked and prepacked for direct sale foods, this means naming the food and listing all ingredients so consumers can identify allergens before purchase. For non-prepacked foods, such as meals served in restaurants or cafés, the FSA’s Best Practice Guidance, published March 2025, recommends written information supported with a clear conversation with customers about their allergy requirements. Businesses should keep accurate ingredient records and inform consumers if they cannot confirm allergen content. Consumers should declare their allergies when ordering food to help businesses take appropriate steps and reduce risk.At present, the FSA has no plans to amend the list of 14 allergens. It continues to monitor trends through research projects, including National Health Service data analysis and the Patterns and Prevalence of Adult Food Allergy study, and works with the British Society for Allergy and Clinical Immunology and other stakeholders to gather evidence on hidden and emerging allergens.

What discussions his Department has had with local authorities on the effectiveness of the implementation of Individual Service Funds under the Care Act 2014.

Under the Care Act 2014, everyone whose needs are met by the local authority (LA) must receive a personal budget as part of the care and support plan. The budget sets out how much of the cost of care will be met by the LA and how much will be met by the adult.Individual Service Funds (ISFs) are one of the ways in which the personal budget can be deployed. It allows for a third-party provider to hold and manage the budget on behalf of the individual.Guidance on ISFs is set out in the Care and Support Statutory (CASS) Guidance, issued under the Care Act 2014. The CASS guidance sets out that LAs should offer ISFs where possible and provide clear information on how they work. Where an ISF arrangement is not available locally, the LA should explore arrangements to develop this offer and should be receptive to requests to create arrangements with specified providers.In addition, and supported by the Department, Think Local Act Personal has produced guidance for LAs on ISFs, which can be found on their website, at the following link:https://thinklocalactpersonal.org.uk/resources/individual-service-funds-isfs-and-contracting-for-flexible-support/The Care Quality Commission is assessing how well LAs in England are delivering adult social care by looking at how they are performing against their duties under Part 1 of the Care Act 2014. The assessments identify LAs strengths and areas for improvement, facilitating the sharing of good practice and helping us to target support where it is most needed.The Department has not had discussions with LAs specifically on the effectiveness of the implementation of ISFs under the Care Act 2014.

What guidance his Department has issued to local authorities on offering Individual Service Funds to patients.

Under the Care Act 2014, everyone whose needs are met by the local authority (LA) must receive a personal budget as part of the care and support plan. The budget sets out how much of the cost of care will be met by the LA and how much will be met by the adult.Individual Service Funds (ISFs) are one of the ways in which the personal budget can be deployed. It allows for a third-party provider to hold and manage the budget on behalf of the individual.Guidance on ISFs is set out in the Care and Support Statutory (CASS) Guidance, issued under the Care Act 2014. The CASS guidance sets out that LAs should offer ISFs where possible and provide clear information on how they work. Where an ISF arrangement is not available locally, the LA should explore arrangements to develop this offer and should be receptive to requests to create arrangements with specified providers.In addition, and supported by the Department, Think Local Act Personal has produced guidance for LAs on ISFs, which can be found on their website, at the following link:https://thinklocalactpersonal.org.uk/resources/individual-service-funds-isfs-and-contracting-for-flexible-support/The Care Quality Commission is assessing how well LAs in England are delivering adult social care by looking at how they are performing against their duties under Part 1 of the Care Act 2014. The assessments identify LAs strengths and areas for improvement, facilitating the sharing of good practice and helping us to target support where it is most needed.The Department has not had discussions with LAs specifically on the effectiveness of the implementation of ISFs under the Care Act 2014.

What steps his Department is taking to ensure that patients with multiple weight-related health conditions who fall below the current NHS eligibility threshold for tirzepatide, also called Mounjaro, are not excluded from other forms of treatment.

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for developing authoritative, evidence-based recommendations for the NHS on whether new medicines represent a clinically and cost-effective use of resources. NICE estimated that approximately 3.4 million people are eligible for tirzepatide to treat obesity.The National Health Service is currently rolling out tirzepatide in primary care, prioritising those with the highest clinical need first. NHS England has worked with clinical experts, integrated care boards, patient and public representatives, healthcare professionals, charities and royal colleges on its prioritisation approach, which it set out in its interim commissioning guidance. This is available at the following link:https://www.england.nhs.uk/publication/interim-commissioning-guidance-implementation-of-the-nice-technology-appraisal-ta1026-and-the-nice-funding-variation-for-tirzepatide-mounjaro-for-the-management-of-obesity/As part of the rollout plans, the NHS will look at different service models, including digital and community options and will speed up roll out if possible. Progress on the NHS rollout of tirzepatide will be reviewed by NICE in three years.For those not currently eligible for tirzepatide, there are a variety of weight management services provided by the NHS and local government. These range from multi-component behavioural programmes to specialist services for those living with severe obesity and associated co-morbidities. All weight management services will have some form of eligibility criteria to ensure that they are targeted at those most likely to benefit. For example, the NHS Digital Weight Management Programme is a behavioural programme primarily aimed at adults living with obesity who also have type 2 diabetes and/or hypertension.

Whether he plans to issue revised guidance on the placement of people with Gender Recognition Certificates who have undergone surgery on hospital wards.

NHS England is currently reviewing its Delivering same-sex accommodation guidance and will ensure that it reflects the Supreme Court’s For Women Scotland Ltd v. The Scottish Ministers ruling, and is aligned with the Equality and Human Rights Commission’s statutory Code of Practice (the Code) when that becomes available.

Whether his Department plans to establish an independent inquiry into the historic prescribing of Diethylstilbestrol.

The issue of diethylstilbesterol (DES) and vaginal carcinoma in the daughters of women who took DES during pregnancy was reviewed by the Committee on Safety of Medicines (CSM) in the early 1970s. In 1973, the CSM wrote to all doctors to inform them of the results of a study into the topic from the United States, and the absence of identified cases in the United Kingdom.The work of the committee predates the existence of the Medicines and Healthcare products Regulatory Agency (MHRA), when medicines vigilance was only in its infancy and there were no electronic records and no systematic monitoring of prescriptions.There has been a step change in reporting and record keeping since this time, and today's regulatory frameworks are significantly different, with much stricter post-authorisation monitoring allowing for earlier identification and action on emerging safety issues. The MHRA regulates medicines supplied in the UK. Its activity spans the whole of a medicine’s lifecycle. The MHRA keeps the safety of all medicines under continual review.Government advice currently is that routine cervical screening is appropriate for those who believe they were exposed to DES in utero. Further information is available at the following link:https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individualsParticipation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.The Department does not have any plans to establish a public inquiry into the historic prescribing of DES.

If his Department will take steps to ensure that historic (a) NHS and (b) GP records can be reviewed to identify women who were prescribed Diethylstilbestrol between the 1940s and 1970s.

The issue of diethylstilbesterol (DES) and vaginal carcinoma in the daughters of women who took DES during pregnancy was reviewed by the Committee on Safety of Medicines (CSM) in the early 1970s. In 1973, the CSM wrote to all doctors to inform them of the results of a study into the topic from the United States, and the absence of identified cases in the United Kingdom.The work of the committee predates the existence of the Medicines and Healthcare products Regulatory Agency (MHRA), when medicines vigilance was only in its infancy and there were no electronic records and no systematic monitoring of prescriptions.There has been a step change in reporting and record keeping since this time, and today's regulatory frameworks are significantly different, with much stricter post-authorisation monitoring allowing for earlier identification and action on emerging safety issues. The MHRA regulates medicines supplied in the UK. Its activity spans the whole of a medicine’s lifecycle. The MHRA keeps the safety of all medicines under continual review.Government advice currently is that routine cervical screening is appropriate for those who believe they were exposed to DES in utero. Further information is available at the following link:https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/5-screening-and-management-of-immunosuppressed-individualsParticipation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.The Department does not have any plans to establish a public inquiry into the historic prescribing of DES.

What steps his Department is taking to ensure full interoperability between NHS IT systems.

The Health and Social Care Act 2022, the Data (Use and Access) Act 2025 and the Health and Social Care Information Standards (Procedure) Regulations 2025, establish a new legislative framework for setting mandatory information standards for public and private health and adult social care providers and IT suppliers in the health and care system. This will provide the basis for ensuring interoperability between IT systems. Mandatory information standards will be introduced in a staged process, allowing for different systems to communicate and share data more effectively.

Whether his Department has made an estimate of the annual cost to the NHS of repeated or unnecessary appointments resulting from poor communication between departments and trusts.

The Department has not estimated the cost to the NHS of any repeated or unnecessary appointments which might conceivably have resulted from poor communication between departments and trusts.